Handling Claims with Multiple Diagnosis Codes

If you enter more than one medical procedure on the same claim and use more than four unique diagnosis codes for all procedures, the Select Transactions For Claim window is displayed.

Medical claim forms can only accommodate four unique diagnosis codes for all procedures on the claim. If you require more than four codes, you can use the Select Transactions For Claim window to change diagnosis codes or to submit the medical procedures on different claims.

The four diagnosis codes are assigned numbers 1—4. The number is attached to each procedure associated with that diagnosis. The top of the Select Transactions For Claim window displays all submitted procedures and their diagnosis codes. The On Claim column displays the diagnosis code numbers (1—4) for each procedure on the claim. An asterisk is displayed for codes that will not fit on the claim form.

To handle claims with multiple diagnosis codes:

  1. To change the diagnosis codes for a transaction, click Edit Diags on the toolbar and edit the Diagnosis Codes fields.

  2. If you need to use more than four diagnosis codes, submit the medical procedures on different claims. Highlight a procedure and click No (submit later) on the toolbar. The Submit option for that procedure is no longer marked. In the patient’s Transactions window, that procedure is labeled Not Sent. Repeat this step until only those procedures using a total of four or fewer diagnosis codes are marked for submission. Click OK.

The Claim record window is displayed for the procedures marked for submission. For more information, see Submitting Dental Claims.